Evaluating the development and well-being assessment (DAWBA) in pediatric anxiety and depression

Abstract

Enhancing screening practices and developing scalable diagnostic tools are imperative in response to the increasing prevalence of youth mental health challenges. Structured lay psychiatric interviews have emerged as one such promising tool. However, there remains limited research evaluating structured psychiatric interviews, specifically their characterization of internalizing disorders in treatment-seeking youth. This study evaluates the relationship between the Development and Well-Being Assessment (DAWBA), a structured psychiatric interview, and established measures of pediatric anxiety and depression, including the Screen for Child Anxiety Related Disorders (SCARED), the Pediatric Anxiety Rating Scale (PARS), and the Mood and Feelings Questionnaire (MFQ). The study comprised two independent clinical samples of treatment-seeking youth: sample one included 55 youth with anxiety and 29 healthy volunteers (HV), while sample two included 127 youth with Major Depressive Disorder and 73 HVs. We examined the association between the DAWBA band scores, indicating predicted risk for diagnosis, the SCARED and PARS (sample one), and the MFQ (sample two). An exploratory analysis was conducted in a subset of participants to test whether DAWBA band scores predicted the change in anxiety symptoms (SCARED, PARS) across a 12-week course of cognitive behavioral therapy. The results revealed that the DAWBA significantly predicted the SCARED, PARS and MFQ measures at baseline; however, it did not predict changes in anxiety symptoms across treatment. These findings suggest that the DAWBA may be a helpful screening tool for indexing anxiety and depression in treatment-seeking youth but is not especially predictive of longitudinal trajectories in symptomatology across psychotherapy.

Keywords: Anxiety; Cognitive behavioral therapy; DAWBA; Depression; Internalizing; Psychiatric interview.

Fig. 1

(a) Correlation between DAWBA Generalized Anxiety Disorder (GAD) band score and the combined Screen for Child Anxiety Related Disorders – Child and Parent Report (SCARED-CP) across both anxious patients and healthy volunteers. (b) Correlation between DAWBA Separation Anxiety Disorder (Sep AD) band score and the combined SCARED-CP across both anxious patients and healthy volunteers. (c) Correlation between DAWBA Social Anxiety Disorder (Social AD) band score and the combined SCARED-CP across both anxious patients and healthy volunteers. Healthy volunteers = blue; anxious patients = red

Fig. 2

Correlation between DAWBA Major Depressive Disorder (MDD) band score and the Mood and Feelings Questionnaire – Child and Parent Report (MFQ-CP) across both depressed patients (red) and healthy volunteers (blue)

Fig. 3

Lines indicate individual participants’ Screen for Child Anxiety Related Disorders – Child and Parent (SCARED-CP) score mapped at each study interval throughout the treatment period. Beginning at baseline and ending at week 12 of cognitive behavioral therapy (CBT), the SCARED-CP was collected four times during the study for anxious participants in treatment. A downward trend would indicate a reduced symptom severity observed by parent/experienced by child

Fig. 4

(a) Correlation between DAWBA Generalized Anxiety Disorder (GAD) band score and the combined parent and child report from the Pediatric Anxiety Rating Scale (PARS) across both anxious patients and healthy volunteers. (b) Correlation between DAWBA Separation Anxiety Disorder (Sep AD) band score and the combined parent and child report from the PARS across both anxious patients and healthy volunteers. (c) Correlation between DAWBA Social Anxiety Disorder (Social AD) band score and the combined parent and child report from the PARS across both anxious patients and healthy volunteers. Healthy volunteers = blue; anxious patients = red

Fig. 5

Lines indicate individual participants’ Pediatric Anxiety Rating Scale (PARS) scores mapped at each study interval throughout the treatment period. Beginning at baseline and ending at week 12 of cognitive behavioral therapy (CBT), the PARS was collected four times during the study for anxious participants in treatment. A downward trend would indicate a reduced symptom severity observed by clinicians